吻合血管第二跖骨头移植重建月骨的应用解剖

Applied anatomy on the second metatarsal bone for the treatment of the Ⅲ or the Ⅳ Kienbock′s disease

目的：为第Ⅲ、Ⅳ期月骨无菌性坏死的修复提供理想的替代体。方法：解剖观测了２２侧成人标本第２跖骨头的血供和神经分布，用万能工具显微镜测量了４０侧第２跖骨头关节面和３０侧月骨近侧关节面的纵、横截面曲率半径、长度和面积，进行了二者间的显著性检验。结果：第２跖骨头血管、神经位置恒定，其关节面与月骨近侧关节面的纵、横截面曲率半径间无显著性差异。结论：第２跖骨头与月骨形态、体积近似，取材方便，植入后稳固，吻合血管易于成活，为月骨重建的较为理想的替代体。

Objective:To provide an ideal succedaneum for the Ⅲ or the Ⅳ Kienbock′s disease. Methods:The courses and distributions of the blood vessels and nerves to the second metatarsal bone were observed on 22 sides of adult foot specimens.The radiuses of curvature,lengthes of vertical and horizontal directions,and area of articular surfaces were measured on 40 second metatarsal heads and 30 lunate bones.Results:The blood vessels and nerves to the head of the second metatarsal bone were constant.The differences of radiuses and lengths of the articular surface between the second metatarsal head were not significant.Conclusions:The head of the second metatarsal bone was an ideal succedaneum for the Ⅲ or Ⅳ Kienbocks diserse.